Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients

Figures & data

Figure 1 Flowchart of study design.

Abbreviation: BLT, bright light therapy.

Table 1 Demographic and clinical features at baseline

Diagnosis			Count		Percent
MDD			14		56
BD-1			4		16
BD-2			7		28
Other demographic features	Overall		Unipolar		Bipolar
	Mean	SD	Mean	SD	Mean	SD
Age (years)	47.6	13.5	46.8	12.2	48.6	13.9
Age at onset (years)	33.7	10.2	33.9	10.2	33.5	9.8
Duration of illness (years)	13.9	11.9	12.9	11.9	15.1	14.1
Previous episodes	5.2	3.6	2.9	1.5	7.5	4.0
Duration of current episode (months)	7.8	9.6	11.1	10.6	4.5	6.4
Season of treatment	Count	Percent	Count	Percent	Count	Percent
Autumn/winter	12	48	5	36	7	64
Spring/summer	13	52	9	64	4	36

Abbreviations: MDD, major depressive disorder; BD-1, bipolar disorder type 1; BD-2, bipolar disorder type 2; SD, standard deviation.

Table 2 Psychometric features from all assessments, both for unipolar and bipolar patients

Scale	Overall		Unipolar		Bipolar
	Mean	SD	Mean	SD	Mean	SD
HDRS-21baseline	19.5	4.4	18.4	4.2	20.9	4.4
HDRS-21week 1	15.3	5.3	13.9	5.7	17.2	4.3
HDRS-21week 3	13.8	5.5	11.9	3.8	16.3	6.5
HDRS-21week 4	13.8	6.1	11.6	5.2	16.5	6.3
HDRS-21week 8	12.2	6.9	9.6	6.4	15.4	6.4
HDRS-6baseline	9.4	2.7	9.0	2.6	9.9	2.9
HDRS-6week 1	7.4	3.4	6.6	3.3	8.4	3.3
HDRS-6week 3	6.8	3.0	5.6	1.6	8.2	3.8
HDRS-6week 4	6.8	3.8	5.4	3.0	8.5	4.3
HDRS-6week 8	5.7	4.1	3.9	2.8	8.0	4.3
MRSbaseline	3.0	2.4	3.2	2.5	2.7	2.3
MRSweek 1	2.4	1.7	2.6	1.7	2.1	1.7
MRSweek 3	2.0	1.7	1.5	1.6	2.8	1.7
MRSweek 4	3.4	2.8	2.4	2.2	4.5	3.1
MRSweek 8	2.7	2.3	2.3	2.3	3.3	2.2
DRRSbaseline	14.5	9.3	13.9	9.8	15.4	9.0
DRRSweek 8	8.1	6.8	6.3	5.2	10.6	8.3
SHAPSbaseline	2.6	3.6	2.9	3.4	2.3	3.9
SHAPSweek 8	2.8	4.5	2.8	4.5	2.9	4.8

Abbreviations: SD, standard deviation; HDRS-21, Hamilton Depression Rating Scale (21 items); HDRS-6, Hamilton Depression Rating Scale (6 items); MRS, Mania Rating Scale; DRRS, Depressive Retardation Rating Scale; SHAPS, Snaith–Hamilton Pleasure Scale.

Figure 2 Mean overall HDRS-21 and HDRS-6 scores.

Notes: Repeated measures showed that mean HDRS scores significantly decreased since the first week of treatment. In comparison with baseline, a significant reduction was observed at week 1, week 3, week 4, and week 8. *P<0.05. **P<0.001.
Abbreviations: HDRS-21, Hamilton Depression Rating Scale (21 items); HDRS-6, Hamilton Depression Rating Scale (6 items).

Figure 3 HDRS-21 scores of unipolar and bipolar patients throughout the study.

Notes: As of week 2, unipolar patients have a significantly better response. *P<0.01 (between unipolar and bipolar patients).
Abbreviation: HDRS-21, Hamilton Depression Rating Scale (21 items).

Figure 4 Patients receiving BLT augmentation in the spring/summer season had a significantly higher remission rate.

Note: No significant differences were found in the distribution of patients within spring–summer and autumn–winter (crosstab).
Abbreviation: BLT, bright light therapy.